Title

Validity of DXA body volume equations in a four-compartment model for adults with varying body mass index and waist circumference classifications

Document Type

Article

Publication Title

PLoS ONE

Abstract

The purpose of this investigation was to determine the validity of 4-compartment (4C) model body fat percent (BF%) estimates when using dual energy x-ray absorptiometry (DXA) derived body volume (BV) equations (4C-DXA1 and 4C-DXA2) in adults with varying body mass index (BMI) and waist circumference (WC) classifications. Each model was compared to a criterion 4C model with air-displacement plethysmography (ADP) generated BV (4C-ADP). Participants were categorized as normal weight (n = 40; NW = BMI<25.0kg/m 2 ); overweight (n = 40; OW BMI = BMI25.0 kg/m 2 ); and overweight with at-risk WC (n = 35; OW BMI +WC = BMI25.0 kg/m 2 and WC88.0cm for women and 102.0cm for men). 4C-DXA1 produced lower BF% than that derived using the 4C-ADP in NW (CE = -3.0%; p<0.001) while 4C-DXA2 was significantly higher (CE = 4.8%; p<0.001). The SEE and 95% limits of agreement (LOA) were lower for 4C-DXA2 (1.24% and ±2.5%, respectively) than 4C-DXA1 (2.59% and ±5.0%, respectively) and proportional bias was present for both (p<0.05). 4C-DXA1 BF% was not significant in OW BMI (CE = -0.5%; p = 0.112) whereas 4C-DXA2 was higher (CE = 4.5%; p<0.001). The SEE and 95% LOA were lower for 4C-DXA2 (1.20% and ±2.9%, respectively) than 4C-DXA1 (1.92% and ±3.9%, respectively) in OW BMI . Proportional bias was present for 4C-DXA1 (p = 0.007), but not 4C-DXA2 (p = 0.832). 4C-DXA1 and 4C-DXA2 produced significantly higher BF% in OW BMI+WC (CE = 2.2 and 2.3%, respectively; both p<0.001). The SEE and 95% LOA remained lower for 4C-DXA2 (1.15% and ±2.5%, respectively) than 4C-DXA1 (1.84% and ±3.8%, respectively). There was proportional bias for 4C-DXA2 (p = 0.020), but not 4C-DXA1 (p = 0.183) in OW BMI+WC . Only one prediction model (i.e., 4C-DXA1 in OW BMI+WC ) revealed valid estimates of BF%. Practitioners are encouraged to use criteria for both BMI and WC when utilizing DXA-derived BV in 4C-models for normal and overweight populations.

DOI

10.1371/journal.pone.0206866

Publication Date

11-1-2018

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